Why Do I Have Urinary Leakage?

Your pelvic floor serves as a vital support system for your pelvic organs. However, research reveals that a significant number of women experience hypertonicity in their pelvic floor muscles, characterized by a contracted and shortened position.

Consider your pelvic floor as you would a trampoline—it must possess the capacity to dynamically lengthen and contract to effectively support your organs, much like a trampoline flexes and rebounds.

Contrary to popular belief, experiencing leakage doesn't necessarily signify weakness. The misconception that strengthening alone can alleviate the issue overlooks a critical aspect: the need for lengthening. Merely focusing on "strengthening" by further shortening already contracted muscles can disrupt motor control and hinder the coordination of relaxation and contraction. Hence, the indiscriminate practice of Kegels may exacerbate symptoms rather than resolve them.

When was the last time you consciously worked on lengthening your pelvic floor? Have you ever received advice to prioritize lengthening over strengthening? The analogy of a bent elbow illustrates this concept aptly: just as a bent elbow struggles to pick up objects without first straightening, a shortened pelvic floor lacks the space to effectively contract further to support the bladder, resulting in leakage.

Pelvic floor hypertonicity (PFH) is prevalent and associated with various urological, gynecological, gastrointestinal, and sexual issues, along with chronic pelvic pain. Despite its high prevalence, Kegels alone aren't the “Gold Standard” for pelvic floor dysfunction. Instead, they risk exacerbating the condition by further shortening an already compromised muscle group, leading to failure.

Having a shortened muscle doesn't necessarily equate to strength. To effectively strengthen a muscle group like the pelvic floor, we must first focus on facilitating its full range of motion through dynamic movements. Despite their small size, the muscle fibers in the pelvic floor are incredibly powerful, akin to those found in your hamstrings.

Moreover, hormonal imbalances, particularly a reduction in estrogen, can contribute to urinary leakage by causing rigidity in the urethra and pelvic floor atrophy. Understanding the root cause of your leakage is essential for effective treatment. Therefore, it's highly recommended to consult with a pelvic floor physical therapist for a personalized assessment and targeted treatment plan tailored to address your specific symptoms. By addressing the underlying issues, you can take proactive steps towards achieving long-term relief and pelvic floor health.

In addressing pelvic floor dysfunction, it's crucial to shift the focus from exclusively strengthening to incorporating techniques that promote both lengthening and strengthening. By understanding and prioritizing the need for balanced muscle function, we can better manage and prevent pelvic floor issues, restoring comfort and confidence.